Apartments and greenery

The Housing First model is a strategic response to homelessness that prioritises permanent and stable housing for people experiencing homelessness. Beginning in the USA in the 1990s, the model has been taken up by several European countries, Canada, and recently the New Zealand Government announced a homelessness package which included NZ$63.4 million (AUS$58.6 million) towards Housing First programs

What is the Housing First model and how does it work?

The Housing First model prescribes safe and permanent housing as the first priority for people experiencing homelessness. Once housing is secured, a multidisciplinary team of support workers can address complex needs through services like drug and alcohol counselling or mental health treatment. However, an individual's engagement with these support services is not required for them to maintain accommodation. Each individual is assisted in sustaining their housing as they work towards recovery and reintegration with the community at their own pace. Housing First is predominantly designed for helping those who are sleeping rough (i.e. those sleeping in improvised dwellings, tents, cars and parks).

While there is some variety in the way the model has been adopted by different countries, the guiding principle of Housing First is that safe and secure housing should be quickly provided prior to, and not conditional upon, addressing other health and well-being issues. In contrast, other models make housing provision conditional, such as by requiring individuals to abstain from alcohol or drug use or comply with mental health programs to qualify for housing. Such approaches can make it hard for those experiencing homelessness to become well enough to qualify for housing or make it difficult to maintain tenancy if they do get into housing.

How did Housing First begin?

The model began in the United States in the early 1990s. There, each Housing First tenancy is managed by a not for profit organisation that makes sure rents are paid on time and that homes are maintained. The selected homes are dispersed throughout neighbourhoods and communities and are not identifiable as different from those around them. This means numbers of stigmatised and vulnerable people aren’t placed in close proximity to one another, which, further research found, led to tenancy failures.

...the guiding principle of Housing First is that safe and secure housing should be quickly provided prior to, and not conditional upon, addressing other
health and well-being issues.

Has housing first been successful in ending homelessness?

An AHURI report published in 2012 examined USA Housing First programs and found that they were successful in retaining accommodation for those people at risk of homelessness. A longitudinal study of 225 people in the USA compared the outcomes of those using traditional services and those using a Housing First program. The research found that 88 per cent of those in the Housing First program retained their housing for two years compared to 47 per cent in the other programs.

European program evaluations have measured results that match or exceed the success achieved in North America across the indicators of ending homelessness for people with high support needs, health and well-being, and social integration.

Housing First programs can also be cost efficient for governments and the community. Data from one Housing First program in the UK found housing a homeless person cost £9,600 per person per year (excluding rent), which was around £1,000 per year less than placing the person in a shelter and nearly £8,000 less than placing them in a high-intensity support service (excluding rent).

Similarly, AHURI research published in 2016 identified that providing housing (albeit not necessarily through a Housing First model) for homeless people in Western Australia saved the health system $4,846 per person per year in the period 2009–12, mainly through people spending fewer days in hospitals and psychiatric care. Supported accommodation programs for people experiencing homelessness also led to an average of $2,397 (in 2011$) in reduced costs for the justice system (e.g. reduced prison time and engagement with police).

Housing First in Australia?

The development of Housing First in Australia has been constrained by the lack of appropriate affordable housing stock necessary to quickly house those experiencing homelessness. To date, Housing First projects have run as pilot programs or with time limited funding, rather than as part of a government supported approach to addressing homelessness. Nevertheless, results from these initial projects have have promising.  An evaluation of the MISHA project by Mission Australia from 2010—2013, which used a Housing First approach, found that after two years 97% of clients were still living in secure housing; and the associated cost savings to government equated to $8,002 per person per year.